Journal of Bashir Institute of Health Sciences

Investigating Low Back Pain Amongst Caregiving Mothers of Children with Cerebral Palsy at NIRM, Islamabad

Hina Javed — 2024-03-14

Background: This study was conducted to determine the prevalence of low back pain among mothers of children with cerebral palsy. To determine the frequency of low back pain among mothers of children with cerebral palsy and to evaluate the severity of symptoms and impact of CP children on mother's LBP. Material and Methods: An observational cross-sectional study was performed using demographic data, the Numeric Pain Rating Scale tool was used to assess the severity of back pain, and the ODI questionnaire was used to assess the low back pain disability. The 105 study participants were the mothers visiting NIRM for their cerebral palsy children rehabilitation in the Physical Therapy department. The ODI tool assessed the restrictions in daily activities due to low back. Data was analyzed through frequency tables in SPSS version 22. Results: Low back pain is prevalent (n=3, mean+ SD, p≤0.05) among mothers of children with cerebral palsy in outdoor visitors of NIRM, Islamabad. Conclusion: This study concluded a statistically high prevalence of low back pain and functional limitations, affecting the quality of life and daily life activities.

Keywords: Numeric Pain Rating Scale; Low back pain; Oswestry disability index; Functional disability; Cerebral palsy

Effect of Diabetes Mellitus on Color Vision

Muhammad Arslan — 2024-03-14

Background: Diabetic retinopathy, is a complication of diabetes, which damages the retina's blood vessels responsible for processing visual information, including color perception. The current study examines the effect of diabetes mellitus on color vision. Objective: The current study examines the effect of diabetes mellitus on color vision. Method: As part of our assessment, we employed the Ishihara color vision test to evaluate our patients' ability to perceive colors accurately. The Ishihara test is a widely used screening tool for detecting red-green color deficiency. It consists of multiple plates featuring variously arranged colored dots. Each plate displays numerals or symbols that individuals with normal color vision can readily identify. However, those with color blindness may have difficulty discerning or recognizing these numerals or symbols on the plates. Results: Among 300 patients, 162 are men (54%) and 138 are women (46%), all diagnosed with diabetes. Of the total patients, 105 individuals (35%) rely on medications to manage their diabetes, and 195 patients (65%) use insulin as part of their treatment. Furthermore, 125 patients (41.67%) have normal color vision, while 175 patients (58.33%) exhibit red-green color impairments. Conclusion: These findings suggest a possible link between diabetes and color vision issues. To establish the exact nature of this association, further investigation and analysis are essential. However, these results emphasize the possibility of shared underlying mechanisms between diabetes and color vision deficits, emphasizing the need for additional research and attention when caring for patients with these conditions.

Impact of Elevated Serum Beta hCG in the Second Trimester on the Incidence of Induced Hypertension in Pregnant Women

Ayesha Ismail — 2024-03-14

Objective: To determine the frequency of pregnancy-induced hypertension (PIH) in pregnant women with raised serum beta HCG in the second trimester. This descriptive study was conducted at the Department of Obstetrics & Gynaecology, Ziauddin University Hospital, Karachi, Pakistan, six months after the approval of the synopsis from April 19 to October 18, 2019. Materials and Methods: All patients who fulfilled the inclusion criteria and visited Ziauddin University Hospital, Karachi, were included in the study. Informed consent was obtained after the procedure, and the risks and benefits of the study were explained. In our research, detailed history was taken from each patient, and BHCG was done using the CLIA method. Those patients with raised BHCG were included in this study, and blood pressure and proteinuria were examined. Estimation of mid-trimester beta HCG can be used to predict the early development of PIH. All the collected data were entered into the proforma attached at the end and used electronically for research. Results: Mean ± SD of Age was 27.9±5.3 years. Gestational Age was 17.3±4.2 weeks, and serum beta HCG levels were 53,469.3±235.2 mlU/mL. Pregnancy-induced hypertension (PIH) was observed in 56 (77.8%) patients. Conclusion: It is to be concluded that pregnancy-induced hypertension is found to be significantly high among pregnant women in our population. PIH is associated with maternal Age and perinatal outcomes. The results suggest that pregnant women and members of their families should be urgently educated to understand the importance of antenatal care.

Investigating the Influence of Career Orientation on Career Satisfaction of Dentists Facing Sexual Harassment in Islamabad, Pakistan

Mishal Khan — 2024-03-14

Background: The study examines the impact of sexual harassment on the career satisfaction of female dentists in Islamabad, Pakistan. It also investigates the moderating role of career orientation. Sexual harassment is a critical concern in healthcare settings globally, and its effects on well-being have been well-documented. However, there is a need to understand its specific impact on female dentists in this context. Materials and Methods: A cross-sectional quantitative design was employed, utilizing a modified questionnaire covering demographic details, sexual harassment experiences, career orientation, and career satisfaction. The study focused on female dentists in private dental clinics and hospitals in Rawalpindi and Islamabad, conducted over a four-month period from April to August 2022. Data was collected through Google Forms, social media platforms, and hard copy submissions. Out of 235 responses received, 5 were excluded due to incomplete information, resulting in a final sample of 230 participants. Results: Demographic analysis revealed that a majority (89.6%) of female dentists were in the 20 to 30 years age range. Furthermore, 198 dentists (86.1%) held BDS-level education. In terms of positions, 58 dentists (25.2%) had managerial responsibilities, while 172 (74.8%) solely performed clinical duties. Most dentists (87.8%) had 1 to 5 years of experience. Reliability analysis demonstrated high internal consistency for the measuring scale items. Correlation analysis revealed no significant correlation between sexual harassment and career orientation. However, a small yet positive correlation was observed between career orientation and career satisfaction. The most noteworthy finding was the negative and moderately strong correlation between sexual harassment and career satisfaction, indicating that higher levels of harassment were associated with lower satisfaction. Conclusion: The study provides valuable insights into the experiences of female dentists facing sexual harassment in Islamabad, Pakistan. It highlights the detrimental impact of sexual harassment on career satisfaction and emphasizes the importance of addressing these issues to enhance the well-being and professional fulfillment of female dentists. Additionally, the study underscores the role of career orientation in moderating this relationship, offering a potential avenue for interventions to mitigate the adverse effects of harassment. Further research with larger sample sizes and inclusion of male healthcare professionals is recommended to enhance the generalizability of the findings. Additionally, future studies should consider incorporating record-keeping sources to validate reports of sexual harassment.

Dental Anxiety in Adult Patients during Oral Surgery At Bacha Khan College of Dentistry, Mardan

Haider khan — 2024-03-14

Background: Dental anxiety, also known as dental phobia, is an intense fear of dental experiences, procedures, and treatments, leading to avoidance or extreme anxiety during dental visits. Objective: The current study aimed to find out the dental anxiety levels in patients visiting dental hospitals for oral surgery procedures in Mardan Medical Complex. Materials and Methods: A comprehensive evaluation was conducted on 101 patients to assess their levels of anxiety, utilizing Corah’s Anxiety Scale. This was a cross-sectional study conducted at Iqra National University, and the data were collected from Bacha khan college of Dentistry, Mardan over the time period spanning from April 2023 to June 2023. A sample size of 101 patients was selected and a standard questionnaire was distributed among the patients to find out about the dental anxiety levels in different patients visiting dental hospitals for oral surgery procedures at Mardan Medical Complex. Finally, the data was analyzed through SPPS statistics software to find out about the significance between the variables. Results: Among 101 patients, 59 were male, while 42 were females. 9.9% of the patients experienced high anxiety during both procedures, such as extraction and dental implant therapy. 29.7 had mild anxiety, 51.4 had moderate anxiety, and 8.9% had severe anxiety (phobia) during extraction, per Corah’s Dental Anxiety Scale. A p-value of 0.027 indicates a statistically significant relationship between oral surgery and anxiety levels. Dentists should consider individual anxiety levels to enhance patient comfort during these procedures. Conclusion: In conclusion, 9.9% of patients experienced high anxiety during both procedures. The p-value (0.027) underscores the importance of recognizing the impact of dental surgery on anxiety, emphasizing the need for tailored care to enhance patient comfort and well-being.

Comparative Analysis of Bronchospasm in Patients with Normal and Difficult Airway during General Anesthesia

Inam Ullah — 2024-03-14

Background: Background: Bronchospasm, a significant tightening of the muscles around the airways, poses diagnostic challenges as its main symptom, wheezing, has various causes. Notably, severe bronchospasm may present without wheezing due to minimal air movement, necessitating comprehensive diagnostic approaches beyond simple auscultation. Objectives: The study aimed to determine the frequency of bronchospasm among patients with normal and difficult airways under general anesthesia and to assess the effectiveness of treatment strategies. Materials and Methods: This retrospective observational study reviewed data from December 2021 to August 2022, involving 100 patients undergoing surgeries under general anesthesia at Shifa International Hospital Islamabad, New Age Medical Center, and Liaquat Memorial Hospital Kohat. Patients were divided based on airway status into normal and difficult airway groups to compare the incidence of bronchospasm and treatment outcomes. Results: The study found a higher prevalence of bronchospasm in patients with difficult airways, where 44.10% (19 out of 43) experienced bronchospasm, unlike the normal airway group, which had no cases. Treatment predominantly involved administering 100% oxygen, deepening anesthesia, and using salbutamol inhalers. Conclusion: The correlation between difficult airways and an increased rate of bronchospasm under general anesthesia is clear, emphasizing the need for vigilant monitoring and specialized care. These findings suggest the importance of preparedness in anesthesia practice to manage bronchospasm effectively, ensuring patient safety and optimal care outcomes.

The Liver Associated Diseases in patient with Diabetes Mellitus from Islamabad Region

Farah Shaikh — 2024-03-14

Background: Type 2 Diabetes is a risk factor for progression of many liver associated diseases such as NAFLD, Hepatitis B and C, HCC, Liver Cirrhosis, Acute kidney diseases, glomerunephrities and obesity. We examined prevalence of advanced liver disease in people of type 2 Diabetes and analyzed the changes in liver, renal and lipid profile as a screening tool. Methods: A Hospital based cross-sectional study was performed and data was collected from hematology, chemistry and clinical Pathology department of Umar diabetic foundation and The diabetic center. In this descriptive study, LFTs, RFTs, Lipid profile and Micro albumin were measured in the diabetic patients.Results: A total of 60 patients from different regions of Islamabad were tested during this time. Amongst which 51 patients were Diabetic, 4 were prediabetic and 5 patients were completely normal with no associated disease. Out of those 51 diabetic patients, 26 were male and 25 were female. Furthermore, 30 out of 51 patients were diagnosed with Non-Alcoholic Fatty liver Disease, which was the highest percentage amongst other associated diseases of our report. Other than this, these diabetic patients also presented with high ratio of acute kidney infections and Obesity.Conclusion: Type 2 diabetes is associated with a large number of liver disorders including fatty liver, cirrhosis, hepatocellular carcinoma, and acute liver failure. In addition, there is an unexplained association with HCV. Moreover, blood parameters such as liver enzymes, RFTs and sometimes lipid profile is also disturbed. Comprehensive strategies need to be developed to incorporate screening, prevention and treatment of type 2 diabetes at a community level.

KEYWORDS

Type 2 diabetes, HCC (Hepatocellular carcinoma), NAFLD (Nonalcoholic fatty Liver disease), Obesity.

Professionalism Among Young Physical Therapists in Pakistan

Haseeb Muhammad Khan — 2024-03-14

Background: The primary objective of a physical therapist's professionalism is to enhance their understanding and expertise within their field, allowing them to practice independently and fulfill their responsibility as a competent professional, hence be accountable to society. The American Physical Therapy Association (APTA) defines professionalism as encompassing seven fundamental elements: Respect, Compassion, Integrity, Altruism, Accountability, Excellence, and social responsibility. The present study aims to assess the level of professionalism exhibited by young physical therapists in Pakistan based on the core values established by APTA. Methods: 100 physiotherapists, with no more than 1 year of experience after completing their graduation, and currently employed in a clinical setting, were selected for inclusion in the study, whereas those with a postgraduate degree or those working in academic or other non-clinical settings were excluded. The research employed a quantitative cross-sectional design, and data was collected using APTA's core-values "self-assessment" tool. Results: According to results 37(45.1%) female and 4(22.2%) male, total 41 physical therapists said that they always respond to the patients/clients’ needs and goals. It was found that 34(41.5%) of them reported of always trying to gain knowledge and seeking improvement in quality of care of the patient. Conclusions: it was concluded that majority of the physical therapists are fulfilling their duties with great care and responsibility. They care about the patients’ needs and concerns and that professionalism is the key element in the field of physical therapy.

Screening of Viral Hepatitis B and C in adult patients visiting Dental Out Patient Department of Mardan Medical Complex, Mardan

Uzair Uddin Ahmad — 2024-03-14

Background: Hepatitis is a liver inflammation, most often caused by viral infection. Among these viruses, hepatitis B virus (HBV) and hepatitis C virus (HCV) infections account for a large proportion of liver diseases around the world. HBV and HCV are the main etiological factors of chronic liver disease, which include hepatocyte carcinoma and cirrhosis. Objectives: This study aimed to determine the Frequency of HBV and HCV in adult patients visiting the Dental Out Patient Department at Mardan Medical Complex, Mardan. Method: This cross-sectional survey was carried out at Mardan Medical Complex (Dental Department), Mardan from February to June 2021. A total of 300 patients of age > 18 years, visited MMC for seeking various dental treatments and dental surgeries. All the patients were tested for Hepatitis B and Hepatitis C virus infections. The immunuchromatoghraphy technique (ICT) was used to determine the frequency of HBsAg and Anti-HCV in the blood samples of the patients. Observed information was analyzed by using SPSS (Statistical Package for Social Sciences) version 20. Result: A total of 300 patients were examined, who meet the inclusion criteria (18-55 years of Age). Out of a total of 300 patients, 133(44.4%) were observed positive for HBV and HCV infections collectively. After screening, 68(22.7%) were detected positive for HBsAg, while the ratio of HCV-positive patients was found positive in 65 (21.7%) cases. The high ratio of HBsAg positivity was found in the age group 25-31year which is 23/93 (7.7%), while Anti-HCV positive ratio was high in the age group 32-38year with percent prevalence in 18/56(6.0%) individuals. The association between spouse patient history and HBsAg, anti-HCV was found significant where (p=0.001) and (P=0.001), respectively. Conclusion: A high frequency of Hepatitis B virus and Hepatitis C virus infections in Mardan was an alarming situation. The overall prevalence of HBV recorded in our study was higher than the prevalence of HCV. High prevalence of HBsAg positivity in the case of Spouse Patient History while in the case of Anti-HCV positivity high prevalence was observed in the case of Shaving by Self.

Biopharming: In Plant Versus Microorganism Recombinant Biopharmaceuticals Production

Mehak Nimra — 2024-03-14

Biopharming is a relatively new field in biotechnology that uses transgenic organisms for the production of vaccines and therapeutic proteins for certain health-related conditions. Biopharming is developing day by day as it is safe, less time-consuming, and less expensive as compared to commercialized drugs that are in use. Many plants and microorganisms are used in biopharming, also known as molecular Pharming. These plants include alfalfa, barley, rice, banana, corn, tomato, potato, and many more. Recombinant vaccines are also produced in economically important microorganisms including some bacteria and yeast. Many of the biopharma drugs are approved by the Food and drug administration and many are under clinical trials. A much new technology implied in biopharming is edible vaccines, which cure disease by oral administration of antigens. This review intends to look at the food crops and microorganisms with a medically oriented new approach. Fundamental developments, discoveries, and advances in biopharming are discussed, and finally to look forward at the future biomedical potential of molecular Pharming.